Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 0904006690 | VA |
NPI | 1003054198 |
---|---|
Provider Name | Mrs. Stephanie Ann Cocci |
First Address | Fresno, CA 93703-2223 |
Second Address | Fresno, CA 93703-2223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2009 |
Last Update Date | 10/05/2011 |